Asmat Huma, Iqbal Romaina, Sharif Fatima, Mahmood Aamer, Abbas Aamir, Kashif Waqar
Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
Department of Community Health Sciences, Aga Khan University Hospital, Karachi, Pakistan.
Saudi J Kidney Dis Transpl. 2017 Mar-Apr;28(2):285-291. doi: 10.4103/1319-2442.202766.
Accurate dry weight estimation (DW) to achieve euvolemia is one of the key objectives of hemodialysis (HD). While conventionally DW is estimated by clinical examination, bioelectrical impedance analysis (BIA) has been proposed as an objective method to determine DW and has been tested extensively in the Western population. We aim to validate BIA for determining DW in a Pakistani population against the conventional clinician's method. This is a single-center validation study conducted at two outpatient HD units of Aga Khan Hospital, Karachi. One hundred and forty-eight DW readings of patients who were on maintenance HD were taken both by BIA technology and by clinical assessment. The clinician was blinded to readings obtained by BIA. Data analysis was carried out using the Statistical Package for Social Sciences (SPSS) version 19. Median age of patients was 63 years (range 12-89). Nearly 54.1% of the samples were female (n = 80). Spearman's correlation between the clinician's estimate and BIA-derived DW showed a correlation coefficient of 0.982, which was statistically significant (P <0.001). This association remained significant when stratified analysis was carried out by dividing the sample into subgroups according to age, gender, body mass index, and total body water content. Inter-rater reliability analysis using the kappa statistics showed almost perfect agreement between the two methods, κ = 0.929 (95% confidence interval, 0.878-0.980, P <0.001). BIA has been validated as a tool for DW assessment of HD patients in Pakistan in comparison to clinical method.
准确估算干体重（DW）以实现血容量正常是血液透析（HD）的关键目标之一。传统上，干体重是通过临床检查来估算的，而生物电阻抗分析（BIA）已被提议作为一种确定干体重的客观方法，并在西方人群中进行了广泛测试。我们旨在针对传统的临床医生方法，验证BIA在巴基斯坦人群中确定干体重的有效性。这是一项在卡拉奇阿迦汗医院的两个门诊血液透析单元进行的单中心验证研究。对148名维持性血液透析患者同时采用BIA技术和临床评估获取干体重读数。临床医生对BIA获得的读数不知情。使用社会科学统计软件包（SPSS）第19版进行数据分析。患者的中位年龄为63岁（范围12 - 89岁）。近54.1%的样本为女性（n = 80）。临床医生的估计值与BIA得出的干体重之间的Spearman相关性显示相关系数为0.982，具有统计学意义（P <0.001）。当根据年龄、性别、体重指数和总体水含量将样本分为亚组进行分层分析时，这种关联仍然显著。使用kappa统计量进行的评估者间可靠性分析显示，两种方法之间几乎完全一致，κ = 0.929（95%置信区间，0.878 - 0.980，P <0.001）。与临床方法相比，BIA已被验证为巴基斯坦血液透析患者干体重评估的一种工具。
